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General NPI Number Information
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NPI Number | 1922269976
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Entity Type | Organization
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Legal Business Name | AMY KOREEN MD PC
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 28 ELM ST
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City | HUNTINGTON
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State | NY
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Zip | 11743-3402
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Country | US
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Telephone | 631-423-8368
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Fax | 631-421-1914
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Provider Business Mailing Address
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Address Line | 28 ELM ST
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City | HUNTINGTON
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State | NY
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Zip | 11743-3402
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Country | US
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Telephone | 631-423-8368
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Fax | 631-421-1914
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY R KOREEN
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Credential | MD PC
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Telephone | 631-423-8369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 184905
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License Number State | NY
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